Examining the Effectiveness of the Cancer Drugs Fund: Are Data Collection Plans Working as Intended?

OBJECTIVES:

The Cancer Drugs Fund (CDF) in England enables early access to promising new cancer technologies, conditional on additional evidence collection to address any clinical uncertainty. This research reviewed NICE CDF exit evaluations to identify whether the data collection plans were met and whether these sufficiently addressed the uncertainty raised in the original NICE evaluation.

METHODS:

Technologies that exited the CDF between 1 October 2016 and 15 June 2022 were identified. NICE Committee papers and final appraisal documents from both the original and CDF exit evaluations were reviewed. Key issues of uncertainty in the original evaluation were extracted alongside details of the data collection plan and the data actually collected by the time of the CDF exit evaluation to compare if these matched and whether the Appraisal Committee considered the uncertainty to be resolved.

RESULTS:

Excluding one terminated evaluation, 20 technologies were identified as having exited the CDF, with only one of these technologies not recommended following CDF exit evaluation. Median time between CDF entry and exit was 35 months. Overall, 6/20 (30.0%) CDF exit evaluations presented data that did not align with the original data collection plan, mainly due to trial data remaining immature or the Systemic Anti-Cancer Therapy dataset failing to collect the appropriate data. Despite ultimately being recommended, 12/20 (60.0%) CDF exit evaluations did not fully resolve the uncertainty from the original evaluation. Of the 14 CDF exit evaluations that presented data aligned with the original data collection plan, only 7 of these (50.0%) fully addressed the uncertainty from the original evaluation.

CONCLUSIONS:

The data collected within the CDF period did not always align with the original data collection plan and most CDF exit evaluations did not fully address the clinical uncertainty identified in the original evaluation. Despite this, recommendation rates of technologies exiting the CDF were found to be high.